Political leaders – we will hold you accountable for the health crisis

Johannesburg, 19th January 2018 – Last week the national leadership of the Treatment Action Campaign (TAC) held our first meeting of the year to plan for the year ahead and take stock of the political developments over the holiday period. The reality is that in 2018, the South African public healthcare system continues to be in crisis. It is poor people who bear the brunt of this dysfunction. We continue to face major HIV and TB epidemics – 7.1 million people have HIV and TB remains our leading cause of death in the country. There are rising rates of drug resistant TB – the WHO estimates 19,000 cases in 2016 up from 7,350 in 2007 – and there are high burdens of other sexually transmitted infections. This is in conjunction with an epidemic of sexual violence across the country.

It is within this context that TAC turns 20. We will mark our 20th anniversary of saving lives with a year of intensified action around HIV, TB and the broken public health system. We will expose the current atrocities in the health system and ensure that those in positions of political power are held accountable and ensure they fix the health system. We will remember and celebrate the lives of our HIV struggle heroes such as Gugu Dlamini – who was stoned to death after revealing her HIV status publicly – and human rights, LGBTQIA+ and HIV activist Simon Nkoli – who died without ever having the opportunity to access HIV treatment.

In February, we will launch the “People’s National Strategic Plan (NSP) on HIV, TB and STIs”. Last year we refused to endorse government and the SA National AIDS Council’s own NSP, a plan that failed to reflect the realities in the healthcare system and the political realities in which this healthcare system exists. There exists a good understanding of what needs to be done to turn the tide against TB, HIV and other STIs – but currently the finances, the human resources, and the management capacity to make it a reality are missing. Our own NSP will outline the people’s plan for the next five years.

While our country’s health system continues to implode, the ruling party grapples with its internal politics. December 2017 was a significant political milestone for the ANC and many pundits view it as moment heralding for the renewal of the party.

We welcome the appointment of Cyril Ramaphosa as ANC President and note our good working relationship with him as the Chairperson of the South African National AIDS Council (SANAC). While we respect the independence of the ANC election process, we note with concern the appointment of Free State Premier Ace Magashule and Mpumalanga Premier David Mabuza into the ANC’s top six leadership. Both men have presided over provinces with broken healthcare systems and are implicated in corruption. As TAC, we can never have faith in these individuals.

We commend the move to decriminalise sex work however while the ruling party has made this commitment, there is no plan or timetable yet to effectively roll this out. Decriminalisation must take place before the 2019 election. All necessary resources needed must be made available to make this a success. Further, government must develop an agenda that goes wider than this, that seeks to empower women and girls more broadly and addresses societal patriarchal norms and widespread violence. This must include a financial commitment and strategy that recognises poor women’s struggles.

We further note the statement of the Economic Freedom Fighters (EFF) acknowledging the challenges in the health system that affect the poor, and prioritising the improvement of our public health facilities in 2018.

We urge all politicians to focus on the real work of delivering services to our people. The 2019 election is predicted to be a watershed moment in our country’s history and we, as TAC, are ready to hold our political leaders accountable. We will engage the new leadership of the ANC through Deputy President Cyril Ramaphosa. We will engage all other opposition parties sitting in parliament as well as Premiers, MECs of Health and Portfolio Committees.

While we commit to increased engagement between TAC and political parties this year – we stress that TAC remains independent from any political parties and our primary responsibility remains to serve the interests of our members and other users of the public healthcare system. That said, direct engagement with political parties in all provinces and at the national parliament appears a promising avenue through which to increase political accountability and to force a more proactive and committed response to the collapse of our healthcare systems.

In the coming weeks we will release TAC reports on the state of the provincial health systems where we work. The evidence is damning. We will urge political parties to thoroughly review the challenges and to ensure solutions are evident in their election manifestos. Ahead of the last election, in 2014, TAC developed a ‘People’s Health Manifesto’ containing 11 key questions put to political parties. However, many commitments made by political parties in response to these questions have been broken. For example, the ANC committed “to appoint appropriately qualified, competent and committed persons as MECs of Health” yet time and again we have seen the opposite to be true with appointments like Sicelo Gqobana in the Eastern Cape, Benny Malakoane in Free State, Qedani Mahlangu in Gauteng.

Going forward TAC leadership is committed to building a strong social justice movement in South Africa. This movement will speak truth to power and be independent of political parties. We cannot isolate one struggle from another – we will support and encourage all struggles for social justice and human rights. This will start with a march of TAC and our partners next week on Monday 22 January to the Life Esidimeni arbitration hearings in Parktown, Johannesburg as former health MEC Qedani Mahlangu is due to finally take the stand.